Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, 15405 Ferrol, Spain.
Parkinsonism Relat Disord. 2013 Nov;19(11):1009-12. doi: 10.1016/j.parkreldis.2013.07.003. Epub 2013 Jul 26.
To investigate whether Parkinson's disease (PD) and dementia are competing risks in subjects with idiopathic rapid-eye-movement sleep behavior disorder (RBD).
The number of incidental PD cases observed in 11 longitudinal RBD studies was compared with the corresponding expected number as estimated by a simple mathematical model based on population parameters for PD age-of-onset.
The expected number of incidental PD cases exceeded observed PD cases (p-value < 0.001) but was in agreement with the sum of observed PD cases and observed mild cognitive impairment/dementia cases (p-value = 0.34). Sensitivity analyses confirmed the results.
In the RBD population, PD and dementia cases are competing risks, suggesting that alpha-synuclein pathology occurs simultaneously in substantia nigra and neocortex. This observation has implications for the design and analysis of trials of neuroprotection.
探讨特发性快速眼动睡眠行为障碍（RBD）患者中帕金森病（PD）和痴呆是否为竞争风险。
将 11 项纵向 RBD 研究中观察到的偶发性 PD 病例数与基于 PD 发病年龄人群参数的简单数学模型估计的相应预期病例数进行比较。
观察到的 PD 病例数低于预期（p 值<0.001），但与观察到的 PD 病例数和观察到的轻度认知障碍/痴呆病例数之和相符（p 值=0.34）。敏感性分析证实了这些结果。
在 RBD 人群中，PD 和痴呆病例是竞争风险，提示α-突触核蛋白病理学同时发生在黑质和大脑皮层。这一观察结果对神经保护试验的设计和分析具有重要意义。
